It’s enough to make any doctor sick

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It’s enough to make any doctor sick

A new recruitment system has thrown the NHS into chaos, says Sarah-Kate Templeton

Dr Andrew Cook has spent the past 10 years training to fulfil his ambition to become a consultant orthopaedic and trauma surgeon. Cook, 29, a junior doctor from Sevenoaks, Kent, studied medicine at Oxford University and Imperial College London and has carried out more than four years of intensive hospital training. He is now considering leaving Britain for Australia or New Zealand, having failed to be selected for interview for one of the 22,000 consultant training posts being filled through the government’s new and “disastrous” online application system. It emerged last week that more than 30,000 doctors had applied for the 22,000 jobs available and that some of the most talented were not even offered a single interview. Frustrated applicants told of the system crashing, senior colleagues unable to submit their references and the application form seeming to favour “waffle” rather than experience and qualifications. Like thousands of other junior doctors, Cook has been caught up in a new system of selecting consultants, the National Health Service’s most senior medics. The majority of the medical profession agreed that the old system of training consultants needed speeding up, but junior doctors, consultants and the prestigious Royal College of Surgeons say the arrangements have been rushed in too quickly. Feelings were running so high last week that panels gathered to interview candidates boycotted the process at the last minute. The government duly announced a review of the selection process and decided to rerun the first of the three rounds of interviews. Junior doctors will be allowed to submit traditional CVs to set out their qualifications clearly and panellists will carry out a more conventional interview rather than relying on the information contained on the computer forms. Junior doctors who do not get a training post to become a consultant in the speciality of their choice will be forced to study an area of medicine they are less interested in or take a less senior hospital doctor job, known as a staff grade doctor, with no prospect of ever becoming a consultant. “If I am not selected for interview in the next round, and the opportunities for me to find a training post next year are very small, then I will look at continuing my training abroad, probably in Australia or New Zealand,” said Cook. “I will do anything I can to continue my career.” NHS managers argue that doctors must realise they cannot all become consultants — the most highly paid of hospital staff — and that the health service also requires less qualified doctors to carry out more routine treatment. While there have always been junior doctors who failed to get the prestigious training posts to become consultants, the fear is that people who should be getting the places are missing out. “There were a lot of young trainees who had not been shortlisted who felt they should have been,” said Professor Dame Carol Black, head of the Academy of Medical Royal Colleges. “We were aware that there were real problems with the application form. The speciality they might most have wanted to enter may have been taken up by people who weren’t as well qualified. “You may argue that this is realism, but you may argue that if you wanted to be a surgeon and the only opportunities are in psychiatry and pathology, are you going to be able to adjust to that? Are you going to make a good pathologist or a good psychiatrist?” Professor Robin Touquet, a consultant in emergency medicine at St Mary’s hospital, London, says the new system is too politically correct and that in trying to make the system more fair the interview panel is not being given enough data to choose the best candidates. One junior doctor complained that instead of being able to give his academic qualifications in full he was asked to “describe how you have dealt with an emergency”. The Department of Health admits there have been teething problems but insists these will be addressed by the review. Ministers also say candidates who are not successful in the first two rounds will be able to reapply next year. Cook remains uncertain about his future: “If I want to practise as a consultant it could mean going back to the beginning to start again in another speciality. Given that I have my membership exams for the Royal College of Surgeons and all the other achievements I have made, that would be daunting.” Like many in his position Cook would not consider a staff grade post, described by some doctors as mere “service provision”. The NHS is consultant-led and doctors such as Cook see themselves as future leaders.

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